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ELECTRICAL.INSPEGTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS <br />Site-Work <br />Underground <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Life Safety /Low Voltage <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bonding / Grounding / UFER <br />Transformers <br />Lorqueing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />nValls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rouqh <br />Ceilings (T-Bar Rouoh) <br />Meter Release <br />Rough <br />Service lvleter <br />FINAL 17/illr 5\r<g <br />Notes, Remarks, Etc. <br />OlVNER BUTLDER DELCARATION <br />I h€r.b, amm unds poahy oI p.rjury lhat I an .x€mpl aron the Conlracrots Licen$ L.w for thc lollowins tc&n (Sd 701 I 5 <br />Butin.ss dd Pror6ion Codc): Any Cny or Counry qhich Erluts a Ddi !o o.srrucl, al!6. inprov( dmolish or r@n &y <br />slruc'ui l,ior lo ns isodc., als reqoirB th. applicd for such p.nnn lo nl. r sign.d sdddl lhal h. or sh. is lics.d pullui <br />ro rh. I,ovniotu olrh€ Conticlois Lic..sd tiw (ClBprd 9. Commcncrns *irh Sdrioo 7000 of Dii.ion I of th. BsinB ed <br />Pru f*ions Codc) or thal hc or shc ii cr@fl tha.liod 4d lhc bdis for lh. 6u.s.d doBnrn. Any riolr(ion oa Sdion 701 L5 by My <br />applica for 0 pmn subjets thc applicaorroa€ililpchah,of.ornoE$e6!.hundr.ddoll&s(S500). <br />-1, <br />*s ow.d ofthc propsly. or dy ehploye *,ith wasa d thct elc .omp.nsarnJn, Nill do lhe sork dd $. nMut is nol <br />inlad.d or ofid.d for $lc (Sa ?044. aNins ed Ptuleio6 C.d. TI. Conlraclois Lic.6. L.w do6 nol a9ply lo u o*n6 ol <br />rhc pmldry tr ho hrildt or inpruv6 thdatr ad who dod such $!ik hins.lf or h6ellor rlrou*h his or h6 own mplot€6. <br />prolidqi thar such hp.o\ @drs s€ mr inladoJ or ofiqsj lor ele lf. horvd'6. rhc boildins or in]p(\'ffir ir $ld wirhin on. yw <br />ofcompl.lion, ih. O*rd Buildd sil! hav. thc t{d6 of pmling fid h. or sh. did not hrild or improvc lhc popdy ftr tnc purro* ol <br />L a oNnd oath. prop6ly, M crctNiv.ly contacring wnh lic6s.d .oitrctou lo cotrnrud rh. Eoj€cl (S{. 7044. &tsd< <br />and PFGsion Cod.: Th. conhcrof s LiccBc L!q, do6 mt apply ro o o*.r or propdry who buil& or impro!6 lh6on. <br />and who ontBcts for such proj.ds *iln a ConrBcto(s) lic6s<d posuel ro Ihc Contrcroai Lic€M IisJ. <br />I imc\empr undcrseclh , B. & l']( lor rhistason <br />D.l€ ostr$: <br />uaaE[al:rauxrlrarla! <br />DEqAAAII9B <br />I hd.by afiinn u.dd penolty ofpdju.y on onhc follouinr ddlmliorel <br />I n,!. md Nill 6ai.rain a c.difi.dc of co6or ro sclllcrc lor rvorksr conrpenMriotr, a pro\ ided aor by Salion l70O o I lhe <br />LahJr Cod€, lor thc p6romuc. oalhc Norl for which rhe psnir is issu€d. <br />I hsv. and Nill mainlain sork€rs' comp.G.tiof, iBra.... s r.quiEJ by s{tion 1700 ollhc L{bor Codc, for lh. pdhmecc oa <br />ihc Nork lbr which lhis perDir is <br />Y <br />My wde6 mmp.ns.rion iNrrecc cmi6 dd policy nunbq dc: <br />3VAt $-uqLr3->l <br />I.dilrrhar in rh. prf.rnBd.c oalhc work foiwhichrhis pd,nir n issu.d,I shall nor onlloy.nyp6on in anym ncr <br />$ 6 Io becoN subl(l to the workss compaslion Lss ol ('alifomia. and asrc thal il t should bccon subjar to rh€ <br />workqs, comp€Nrion lrovisioG olS.clion 3700 oflhc L.bo! ( ode I slnll.lonhwilh comply{nh rh.e povirions <br />WARNINC Failure lo Kuc {oik6' com!.$.rio. co!@s. is uniasaul, ind shall subj* an dnplorq lo oiminal rE 6 d <br />cilil n.cs up lo oDc hu rcd thousdd dollds ($100.000). in addition ro t ni.. danag.s .s provided fo, rhc <br />Seclion 1076 olthe Labor CGle. inlr6r dd <br />lq IY <br />DECLAAdIIAN <br />I h.Eby amm under pnahy o f pdjury rhd I &n lico3.d u.dd provirio. ofchatlc 9 (commacingwith Sdtion 7000)olDnision 3 <br />of lh€ Busins ad Prolsios Cod€. ad my licow is in lull forcc od cfld. <br />Dcrq ll <br />ol <br />I "*,,*.. A6 C <br />colualtro!.tEtDldclc[lcr <br />I h6.by.flinn undd FrhyofFjuryrhd th6. isa codocrion k dinB a86cy for lh. Ffonn c€ollh.work lor which lhi! pomir t <br />iss!.d{sc. :1097. civ. c.}. <br />AttUC IfDECL S.lIIl! <br />I h6rty.llim undo pd,lly olpdjury o,c olrhe follo{ih! d$ldalions: <br />Dnohrion P€uits'Asb6kx Norificalion Fcdoal RcBulalions (rnk a0. Pan6) <br />R.qtrtrcJ I cro olNorliorir!, <br />-l <br />colify thal rhe aed6.l resu lar ions rc3adin8 ab€stos rcmor.lde nor arplicahlc to rhis proje.1. <br />)ql col,ly rhar I ha'e rcad rhis rppltarioi rEdsr2rerhal rhcahrc 'nlonn.ri(nr <br />s.ordr I .sr& 6 comply \rnh allCily and County <br />o nrn..s rnd Sr e I r\s rchrin! ro buLlJm!.o aurhrria r.frdariv6 orrhis Cn, Md cou ylooislponthc <br />.h\v. nurnrnc! popdy ror <br /> ppli.rnl or Arent Si!trrltrrr <br />,*u* *.",0*u,(1{21g.L;t\7Lu <br />*," rr lrq{ lA <br />slzulT <br />() <br />lq a <br />I-end.rs Ad.tr63: <br />[ ---r------